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I often see patients who've been to poor quality IVF clinics. Now I can understand that they may go to a bad clinic for their first cycle because they don't know any better, but by the time they've done a second and third cycle they should be able to start realizing that the quality of care they're getting is very poor. When there's no transparency; no documentation; no counselling; and they don't get any photos of their embryos, these are clear fed flags that the quality of care is poor. However, they continue going to the same clinic even though they are not happy with the doctor.

I can't understand this ! Why can't they switch doctors and look for a better clinic, now that they are better judges of IVF treatment, since they have been through an IVF treatment cycle ?

Part of the reason is that a lot of IVF patients are scared and confused. What they crave is certainty. Because there's so much information on the internet and so much of it is wrong, they don't know whom to trust . This is why they usually take the path of least resistance - find a doctor and then repose all their trust in him.

They are also reluctant to ask questions or challenge their doctor. They've been told all their life that they're just patients , and are not as smart as doctors are. The standard advice is that a little knowledge can be dangerous , they should let the doctor make all the decisions, because he is an expert in the field. This has been the traditional practice in India, where the doctor has always played a paternalistic role. This is why patients are reluctant to get a second opinion. They end up settling for second best because they're paralyzed, and don't want to take the time and trouble to find another doctor.

They justify their inertia by saying, " At least my old doctor knows my case. How do I know that the new doctor will be any better?" This is flawed reasoning. Once you've experienced one doctor , you automatically become a much better informed patient, and can be much more thoughtful about choosing a better doctor.

There is also the problem of cognitive dissonance. Since patients have invested time and energy in selecting their first IVF doctor, they are not willing to acknowledge that they may have made a bad choice. It's much easier to continue fooling themselves, rather than take the time and effort to find someone else. This just means they are compounding their error. It's best to think of the failed IVF cycle as a sunk cost, and use the lessons you have learned to find a better doctor !

Part of the problem is that IVF doctors take advantage of this indecisiveness of patients, and therefore will pressurize patients into making a decision quickly, which is not always in their best interest. They don't give them time to think or to consider alternative options.

This is why patients continue clutching at straws. Hope springs eternal , and they don't dare to question their doctor . They are quite happy to suspend disbelief, and say, "Even if he doesn't give me photos of my embryos, he must be a good doctor because my sister-in-law got pregnant with him." This is wishful thinking, and can end up hurting the patient, who cannot afford to take such a laid back and casual attitude.